Laparoscopic excision of a retroperitoneal pseudocyst using a modified medial approach: A case report

INTRODUCTION: Retroperitoneal pseudocysts of non-pancreatic origin are rare. Although the laparoscopic approach has been used for their treatment, laparotomy remains the mainstream strategy for these lesions. PRESENTATION OF CASE: We report the case of an asymptomatic 51-year-old male patient who was incidentally diagnosed with a retroperitoneal pseudocyst. Computed tomography showed a 3 × 3 cm cystic lesion in the retroperitoneum, localized between the third part of the duodenum and the inferior vena cava. The patient underwent complete laparoscopic excision using a modified right-sided colonic resection procedure (modified medial approach), and histopathological examination revealed a non-pancreatic retroperitoneal pseudocyst. The patient was discharged without any complications, and no postoperative recurrence was detected. DISCUSSION: Complete excision is of great significance in the treatment of retroperitoneal cysts. There have been few studies on the laparoscopic approach for retroperitoneal pseudocysts. A laparoscopic procedure is less invasive and helps identify the correct tissue planes to ensure complete resection and prevent inadvertent injury to adjacent vital structures. We detached the retroperitoneal lesion from the duodenum and safely removed it without damaging the surrounding organs by a modified medial approach. CONCLUSIONS: Retroperitoneal pseudocysts can be resected laparoscopically by identifying the correct tissue planes and adjacent vital structures.